Hypertensive crisis: symptoms, first aid and when to call 103

Other names: Гипертонический криз, гипертензивный криз, резкое повышение давления, скачок давления, высокое давление 180, криз давления, неотложное состояние при гипертонии

Hypertensive crisis is a sudden significant increase in blood pressure, usually up to 180/110 mmHg. Art. and higher, which is accompanied by a deterioration in health or threatens organ damage. A distinction is made between a complicated crisis, in which the brain, heart, kidneys or blood vessels are affected, and an uncomplicated crisis - without signs of such damage. A complicated crisis can manifest itself as a stroke, heart attack, pulmonary edema, aortic dissection and requires immediate call 103 and treatment in a hospital. Most often, crises occur in people with poorly controlled hypertension, when they skip or stop taking medications on their own, when they are stressed, or when they consume alcohol and large amounts of salt. The main prevention is regularly taking prescribed therapy and monitoring blood pressure at home.

🧾 МКБ-10: I10, I67.4 🏥 Where it is treated: 6 Blood pressure 180/110 and aboveComplicated crisis - call 103Reduce pressure gradually

👨‍⚕️ Which doctor

Cardiologist, therapist, in case of complications - neurologist and emergency doctors

🔬 Diagnostics

Blood pressure measurement, ECG, creatinine, urinalysis, fundus examination, ABPM, EchoCG

💊 Treatment

Gradual reduction in blood pressure under the supervision of a physician, correction of ongoing therapy

📈 Prognosis

In an uncomplicated crisis, favorable; in case of complications depends on organ damage

⚠️ At risk

Irregular medication use, stress, alcohol, excess salt, kidney disease, pregnancy

⏱ When to see a doctor

Emergency for symptoms of organ damage - 103; uncomplicated - urgent contact with a doctor

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Сильная боль или давление в груди — звоните 103
Слабость в руке или ноге, асимметрия лица, нарушение речи
Одышка, удушье, кашель с пенистой мокротой
Внезапная сильнейшая головная боль, спутанность сознания, судороги
Резкое ухудшение зрения, вспышки или пелена перед глазами
Высокое давление у беременной, особенно с отёками и головной болью

What is a hypertensive crisis and what types are there?

With a sharp rise in pressure, the vessels do not have time to adapt, and organs sensitive to pressure load begin to suffer. Doctors evaluate not only the numbers on the tonometer, but also the presence of signs of damage to target organs: the brain, heart, kidneys, retina, aorta. Tactics depend on this. In case of a complicated crisis, the pressure is reduced in the hospital using intravenous drugs under constant monitoring. In an uncomplicated crisis, the pressure is usually reduced with tablets gradually, over several hours or days.

Uncomplicated - no signs of acute organ damage
Complicated with hypertensive encephalopathy or stroke
Complicated by acute coronary syndrome
Complicated by acute heart failure and pulmonary edema
Complicated by aortic dissection
Crisis with preeclampsia in pregnant women

Causes and risk factors

Most crises develop in people who already suffer from hypertension but are not treated regularly. A common situation is skipping pills, stopping medications on your own when your blood pressure is “normal,” taking medications only when you feel unwell. A crisis is provoked by emotional stress, alcohol, salty foods, lack of sleep, sudden changes in weather, and refusal of treatment. Less commonly, the cause is secondary forms of hypertension: diseases of the kidneys and renal arteries, adrenal tumors, thyroid diseases, sleep apnea syndrome. Some painkillers, decongestants, and stimulants can increase blood pressure.

Irregular use of antihypertensive drugs
Self-cancellation of treatment
Stress and lack of sleep
Alcohol and excess salt
Kidney and adrenal diseases
Non-steroidal anti-inflammatory drugs, vasoconstrictor drops
Pregnancy with preeclampsia

Symptoms

Typical manifestations are headache, often in the back of the head, heaviness in the head, dizziness, tinnitus, nausea, flashing “spots” before the eyes, redness of the face, palpitations, and a feeling of anxiety. In some people, even very high blood pressure is almost asymptomatic, so you can’t rely only on how you feel. Signs of complications are pressing pain behind the sternum, shortness of breath, cough with foamy sputum, weakness or numbness of half the body, speech impairment, confusion, sharp deterioration of vision, convulsions, tearing pain in the chest or back.

Headache, heaviness in the back of the head
Dizziness, tinnitus
Nausea, vomiting
Flashing "flies" before the eyes
Palpitations, anxiety
Chest pain and shortness of breath with complications
Neurological symptoms of brain damage

First aid and diagnostics

If you have high blood pressure, you need to sit or recline, calm down, and repeat the measurement after a few minutes on the same arm. If there are signs of a complication, call 103 immediately. In an uncomplicated crisis, you can take the drug previously recommended by your doctor for such situations and contact him. You cannot sharply reduce blood pressure with several tablets in a row: this is dangerous for the brain and heart. In a medical institution, an ECG is taken, blood and urine are examined, the fundus of the eye is examined, and if complications are suspected, CT, echocardiography and other studies are performed.

Sit down, calm down, repeat the measurement
If you have alarming symptoms, call 103 immediately
Do not take several different medications in a row
ECG and troponin for chest pain
Creatinine, urinalysis
Fundus examination
CT scan of the brain for neurological symptoms

Treatment after a crisis and prevention

After a crisis, you need to see a cardiologist or therapist in the coming days. The doctor finds out the cause, if necessary, prescribes daily blood pressure monitoring, echocardiography, tests to look for secondary hypertension, and selects permanent therapy. The target pressure for most patients is below 140/90 mmHg. Art., and with good tolerance - below 130/80. The drugs are taken daily, even when the blood pressure is normal. Lifestyle changes are important: limiting salt, quitting smoking and alcohol, losing weight, regular physical activity. It is useful to keep a blood pressure diary at home.

Daily intake of prescribed medications
Home blood pressure monitor and blood pressure diary
Limiting salt
Quitting smoking and alcohol
Losing excess weight
Regular physical activity
Scheduled visits to the doctor to adjust therapy

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Консультация кардиологаfrom 250 000 СМАД (суточное мониторирование артериального давления)ЭКГ с расшифровкойfrom 50 000 ЭхоКГ — эхокардиография (УЗИ сердца)from 165 000 Креатининfrom 50 000 Общий анализ мочи (ОАМ)from 50 000

Frequently asked questions: Hypertensive crisis

At what pressure should you call an ambulance?+

Not only numbers, but also symptoms are decisive. Call 103 if your blood pressure is high and there is chest pain, shortness of breath, weakness in an arm or leg, difficulty speaking, confusion, severe headache or blurred vision. Blood pressure of 180/110 or higher without symptoms also requires urgent contact with a doctor.

How quickly can you reduce blood pressure during a crisis?+

A sharp decrease in pressure is dangerous: the brain and heart are accustomed to high numbers and may suffer from a lack of blood flow. In an uncomplicated crisis, the pressure is reduced gradually over several hours. Do not take multiple tablets in a row or exceed the dose recommended by your doctor.

What to do before the ambulance arrives?+

Sit or recline with your head elevated, loosen tight clothing, allow air flow, do not walk. Record your blood pressure numbers and the time your symptoms started. If your doctor has previously recommended a drug for such cases, take it. For chest pain, do not take anything other than what your health care provider or doctor recommends.

Why do hypertensive crises recur?+

Most often due to irregular treatment: pills are missed or taken only when feeling unwell. Crises are also provoked by alcohol, salt, stress, and some painkillers. Sometimes the cause is secondary hypertension, such as kidney or adrenal disease. The doctor will help you find the cause and select permanent therapy.

Is hypertensive crisis dangerous during pregnancy?+

Yes. High blood pressure in a pregnant woman can be a manifestation of preeclampsia, a dangerous condition for mother and child. If your blood pressure is 140/90 or higher, headache, swelling, flashing spots, or pain in the upper abdomen, you should urgently contact an obstetrician-gynecologist, and in case of severe symptoms, call 103.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.